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评估INTELLECT认知行为疗法移动应用程序对有风险的日本员工焦虑和抑郁症状的疗效:随机对照试验。

Assessing the Efficacy of the INTELLECT Cognitive Behavioral Therapy Mobile App for Anxiety and Depressive Symptoms Among At-Risk Japanese Employees: Randomized Controlled Trial.

作者信息

Yokomitsu Kengo, Oimatsu Riki, Toh Sean Han Yang, Sündermann Oliver

机构信息

School of Psychological Sciences, University of Human Environments, 9-12, Dougo-himata, Matsuyama, Ehime, Japan, 81 899267007.

Intellect Japan Co, Ltd, Tokyo, Japan.

出版信息

JMIR Mhealth Uhealth. 2025 Jun 24;13:e60871. doi: 10.2196/60871.


DOI:10.2196/60871
PMID:40554801
Abstract

BACKGROUND: In Japan, the prevalence of anxiety and depressive symptoms within the working population has risen. This has been accentuated by the economic repercussions of the COVID-19 pandemic and the social isolation resulting from remote work setups. Mobile health apps, particularly those incorporating cognitive behavioral therapy (CBT) features, have shown potential in addressing these symptoms. These self-guided CBT interventions hold promise in alleviating the heightened depressive and anxiety symptoms often observed among Japanese employees. OBJECTIVE: Using a randomized controlled trial, we compared the efficacy of the "INTELLECT" app against a no-treatment control group in improving depressive symptoms and CBT skills among Japanese full-time employees at postintervention and 2-month follow-up. METHODS: A total of 123 full-time Japanese employees were randomly allocated to either the intervention group (INTELLECT), where they engaged with self-help CBT features, or to a control group receiving no treatment. Intervention participants were required to engage with these features for at least 20 minutes per week over a span of 4 weeks. Weekly self-reported assessments were collected from all participants starting from baseline and continuing until the end of the 4-week intervention period. Subsequent assessments were conducted at 1-month and 2-month follow-up intervals. Linear mixed models were used to evaluate any effects of the self-guided intervention on depressive symptoms, as measured by the Patient Health Questionnaire-4, and cognitive behavioral skills, as measured by the Cognitive Behavioral Therapy Skills Scale. The app's feasibility, usability, and acceptability ratings were also examined using the Implementation Outcome Scales for Digital Mental Health (iOSDMH). RESULTS: The final sample (n=73) consisted of 46 (63%) participants who were female, 23 (32%) participants who were male, and 4 (6%) participants who identified as other genders, with a mean age of 40.4 (SD 10.7) years. Significant time × group interactions were found at postintervention and 2-month follow-up, with the intervention group (n=34) reporting significantly lower depressive symptoms than the control group (n=38) at postintervention (t364.7426=-2.243; P=.03; Cohen d=-0.57, 95% CI -1.07 to -0.06) and 2-month follow-up (t364.6948=-3.284; P<.001; Cohen d=-0.85, 95% CI -1.38 to -0.32). In addition, intervention participants reported significantly greater improvements in self-monitoring cognitive skills than control participants at postintervention (t120.7526=2.672; P=.01; Cohen d=0.68, 95% CI 0.17 to 1.18) but not follow-up (t121.5475=1.947; P=.05; Cohen d=0.50, 95% CI -0.01 to 1.02). CONCLUSIONS: This study provides evidence that CBT features on the INTELLECT app are effective in improving depressive symptoms and self-monitoring cognitive skills.

摘要

背景:在日本,在职人群中焦虑和抑郁症状的患病率有所上升。2019冠状病毒病疫情的经济影响以及远程工作模式导致的社会隔离加剧了这一情况。移动健康应用程序,特别是那些包含认知行为疗法(CBT)功能的应用程序,已显示出缓解这些症状的潜力。这些自我引导的CBT干预措施有望减轻日本员工中经常出现的抑郁和焦虑症状。 目的:通过一项随机对照试验,我们比较了“INTELLECT”应用程序与无治疗对照组在干预后及2个月随访时改善日本全职员工抑郁症状和CBT技能的效果。 方法:总共123名日本全职员工被随机分配到干预组(INTELLECT),他们使用自助CBT功能,或分配到不接受任何治疗的对照组。干预组参与者需要在4周的时间内,每周使用这些功能至少20分钟。从基线开始,每周收集所有参与者的自我报告评估数据,直至4周干预期结束。随后在1个月和2个月的随访间隔进行评估。使用线性混合模型评估自我引导干预对抑郁症状(通过患者健康问卷-4测量)和认知行为技能(通过认知行为疗法技能量表测量)的任何影响。还使用数字心理健康实施结果量表(iOSDMH)检查了该应用程序的可行性、可用性和可接受性评分。 结果:最终样本(n = 73)包括46名(63%)女性参与者、23名(32%)男性参与者和4名(6%)其他性别参与者,平均年龄为40.4(标准差10.7)岁。在干预后和2个月随访时发现了显著的时间×组间交互作用,干预组(n = 34)在干预后(t364.7426 = -2.243;P = 0.03;Cohen d = -0.57,95%置信区间-1.07至-0.06)和2个月随访时(t364.6948 = -3.284;P < 0.001;Cohen d = -0.85,95%置信区间-1.38至-0.32)报告的抑郁症状明显低于对照组(n = 38)。此外,干预组参与者在干预后报告的自我监测认知技能改善显著大于对照组(t120.7526 = 2.672;P = 0.01;Cohen d = 0.68,95%置信区间0.17至1.18),但在随访时没有(t121.5475 = 1.947;P = 0.05;Cohen d = 0.50,95%置信区间-0.01至1.02)。 结论:本研究提供了证据,证明INTELLECT应用程序上的CBT功能在改善抑郁症状和自我监测认知技能方面是有效的。

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本文引用的文献

[1]
A chatbot to improve adherence to internet-based cognitive-behavioural therapy among workers with subthreshold depression: a randomised controlled trial.

BMJ Ment Health. 2024-1-10

[2]
Mobile Behavioral Health Coaching as a Preventive Intervention for Occupational Public Health: Retrospective Longitudinal Study.

JMIR Form Res. 2023-10-20

[3]
Preliminary effectiveness of an evidence-based mobile application to promote resilience among working adults in Singapore and Hong Kong: Intensive longitudinal study.

Digit Health. 2023-5-30

[4]
Efficacy of Intellect's self-guided anxiety and worry mobile health programme: A randomized controlled trial with an active control and a 2-week follow-up.

PLOS Digit Health. 2023-5-24

[5]
Efficacy of the Mental Health App Intellect to Reduce Stress: Randomized Controlled Trial With a 1-Month Follow-up.

JMIR Form Res. 2022-12-14

[6]
Efficacy of the Mental Health App "Intellect" to Improve Body Image and Self-compassion in Young Adults: A Randomized Controlled Trial With a 4-Week Follow-up.

JMIR Mhealth Uhealth. 2022-11-21

[7]
Job stress and loneliness among desk workers during the COVID-19 pandemic in Japan: focus on remote working.

Environ Health Prev Med. 2022

[8]
The Effect of Mental Health App Customization on Depressive Symptoms in College Students: Randomized Controlled Trial.

JMIR Ment Health. 2022-8-9

[9]
Economic crisis and mental health during the COVID-19 pandemic in Japan.

J Affect Disord. 2022-6-1

[10]
Japanese Version of the Mobile App Rating Scale (MARS): Development and Validation.

JMIR Mhealth Uhealth. 2022-4-14

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